不完全川崎病32例临床分析  

Clinical analysis of 32 cases of incomplete kawasaki disease.

作　　者：李莉[1] 

机构地区：[1]遂宁市中心医院儿科,四川遂宁629000

出　　处：《四川医学》2010年第6期748-750,共3页Sichuan Medical Journal

摘　　要：目的总结不完全川崎病患儿的临床表现及心血管系统的并发症,为提高川崎病的诊断率与预后提供临床依据。方法回顾性研究1998～2009年我科住院的不完全川崎病32例,分析出现的各种临床表现的发生率及发生冠状动脉病变的危险因素。结果①32例中,男22例,女10例;男女比例为2.2∶1,年龄分布以婴幼儿为主,发病季节以春、夏为主;就诊前平均发热天数7.6d,除发热外,其他症状出现频率依次是:口腔粘膜病变31例(96.8%),球结膜充血30例(93.7%),皮疹24例(75%),淋巴结肿大23例(71.9%),指、趾端脱皮14例(43.8%),合并肺炎7例(21.9%),胃肠功能紊乱12例(37.5%),转氨酶升高11例(34.4%),凝血功能异常14例(43.8%),无菌性脑膜炎1例(3.1%)。②心血管改变情况:治疗前合并冠状动脉扩张10例(31.3%),心房心室扩大6例(18.8%),心电图改变8例(25%)。治疗10 d新发冠状动脉扩张2例(6.3%)。结论不完全川崎病冠状动脉病变的发生率较高,其冠状动脉病变与性别、发热持续时间、血沉、C反应蛋白及血小板计数有关。Objective The aim of the study was to review the cases of Kawasaki Disease（KD）and analyze the clinical features especially their cardiac complications.Methods Totally 32 patients with KD were hospitalized from 1998 to 2009.Their clinical features and factors associated with increased risk of coronary attery aneurysms were reviewed.Results ①Among the 32 KD patients,22 were male and 10 were female.The male-female ration was 2.2∶1.Most of them were infants.Seasonal peak was in spring and summer.All patients had fever,lasting for 7.6 days in average.Other clinical features were oral mucosal changes（31 patients.96.8%）,conjunctivitis（30 patients,93.7%）,rash（24 patients,75%）,cervical lymphadenopathy（23 patients,71.9%）,changes in the extremities（14 patients,43.8%）,complicating pneumonia（7 patients,21.9%）,gastrointestinal function disorders（12 patients,37.5%）,elevated aminotransferase（11 patients,34.4%）,blood coagulation disfunction（14 patients,43.8%）and aseptic meningitis（1 patients,3.1%）.②Before the tratment,coronary artery abnormalities（10 cases,31.3%）,atrial and ventricular enlargement（6 cases,18.8%）,changes in ECG（8 cases,25%）and the new cases of coronary artery abnormalities ten days later（2 cases,6.3%）.Conclusion The cases of Kawasaki Disease with coronary artery abnormalities were easy to be found.The factors which caused oronary artery abnormalities were concerned with sex.fever duration and the counts of C-reactive protein/erythrocyte sedimentationrate and platelets.

关 键 词：皮肤粘膜淋巴结综合症 不完全 临床表现 冠状动脉病变 危险因素 

分 类 号：R725.4[医药卫生—儿科]